What is arthrosis? Causes, symptoms and treatment of pathology

Arthrosis is a chronic pathology aimed at damaging the articular structures of the locomotor system. The main reason leading to chronic disease is metabolic imbalance, which leads to a progressive process of a degenerative-dystrophic nature. The targets of the damaging reaction are articular cartilage, connective tissue, bursae, tendons, bones and muscle corset. In the chronic form of the pathology, periarticular muscles are involved in the inflammatory process, losing anatomical elasticity due to joint deformation and swelling. To eliminate complications associated with blocking the biomotility of the skeleton, and not become disabled, you need to arm yourself with information about arthrosis - what it is, what are the causes, symptoms and treatment.

Causes and risk factors for the development of pathology

The inflammatory-destructive process in joints often begins for no reason. Idiopathic (primary) arthrosis has this onset. The mechanism of development of secondary arthrosis starts after certain conditions and factors, namely:

• Joint injury (fracture, meniscal damage, ligamentous rupture, dislocation, compression + bruise, bone fracture).
• Dysplasia (abnormal intrauterine development of articular components).
• Violation of material metabolism.
• Pathologies of the autoimmune type (rheumatoid arthritis, psoriasis, autoimmune toxic goiter, systemic lupus erythematosus).
• Nonspecific destructive arthritis (with a purulent component).
• Infections of various etiologies (tuberculosis, meningitis, encephalitis, gonorrhea, syphilis, hepatitis).
• Pathologies of the endocrine glands (diabetes mellitus, toxic goiter, pathology of the adrenal glands and pituitary gland).
• Hormonal dysfunction (decreased levels of estrogens, androgens).
• Degenerative + dystrophic reactions (multiple sclerosis, Perthes disease).
• Oncological diseases.
• Blood diseases (hemophilia, anemia, leukemia).

Risk factors that provoke and lead to arthrosis:

1. Age-related changes.
2. Obesity (excess body weight leads to constant vertical loads, which overload the joints, which quickly wear out, losing cartilaginous plates).
3. Professional costs, that is, the load on a certain group of joints, which leads to their inflammation or premature destruction before other groups.
4. Postoperative consequences: highly traumatic surgery with extirpation of affected tissues (soft, cartilaginous, bone). After restorative manipulations, the joint structure does not have the same consolidation, so any load leads to arthrosis.
5. A hereditary factor, that is, arthrosis can affect one or more family members.
6. Hormonal imbalance during menopause or after extirpation of the ovaries in women, prostate gland in men.
7. Violation of water-salt balance.
8. Neurodystrophic damage to the spinal column is a trigger for glenohumeral, lumbosacral and hip arthritis-arthrosis.
9. Intoxication with pesticides, heavy metals.
10. Temperature variations with sudden changes plus hypothermia.
11. Permanent trauma to a certain group of joints.

Risk factors include the environment, which has recently been saturated with high background radiation, toxic substances (smog over industrial cities and in industrial zones, as well as frequent testing of military equipment or interstate wars, the result of which are ozone holes + strong ultraviolet radiation). Dirty drinking water + foods rich in preservatives lead to the development of arthrosis.

The mechanism of arthrosis development

The basis for the triggering mechanism of arthrosis is a disruption of the chain of restoration processes of cartilage cells and correction of the affected connective tissue areas by young cells. Cartilaginous plates tightly cover the terminal surfaces of the bones that are part of the locomotor joints. Normal cartilage anatomically has a strong structure, they are smooth, elastic, and thanks to synovial fluid, which is a biological material for lubricating intra-articular components, they are gliding. It is the synovial fluid that gives unhindered movement of the articular components relative to each other.

Cartilage tissue and synovial lubrication perform the main function of the shock-absorbing effect, reducing the abrasion of bones covered with cartilage. The bony ends are separated by bags of fluid, and a corset of ligaments and muscles firmly stabilizes them. A certain configuration and plexus of the muscular-ligamentous apparatus allows this structure to perform precise biomechanical movements such as flexion, extension, rotation + rotation. The design, thanks to the interweaving of ligaments, allows you to firmly hold in a certain position, as well as perform coordinated movements, maintaining the balance of the body.

High stress or hormonal imbalance leads to the destruction of collagen plates, exposing the bones. Pointed osteophytes appear in these areas; they create pain with any movement of the musculoskeletal joints. The bones thicken, and false joints develop between the osteophytes, which completely change the functionality of the organ of movement. There is less synovial fluid due to trauma to the bursa (its rupture), and the entire joint structure begins to suffer, along with the corset of ligaments + muscles. Joint swelling appears, and a microbial infection may also occur. Ossification zones lead to limited movement and ankylosis of the joint.

Stages of clinical manifestation of joint pathology: stages

Arthrosis is characterized by three stages of development, consisting of:

• Stage I:there are no special morphological changes, trophism is not disturbed, synovial fluid is produced in sufficient quantities. The stability of the joint structure corresponds to average physical activity. With forced work, pain and swelling of the joint appears.
• Stage II:depletion of the cartilaginous plate is observed, foci of osteophytic islands develop, and ossification appears along the edges of the joint. The pain syndrome intensifies, swelling increases, and discomfort in movement appears. As the pathology progresses to the chronic stage, the pain is constant, it is accompanied by inflammation with periods of exacerbation/remission. The biomechanics are partially impaired, the patient spares the joint.
• Stage III:the cartilaginous plate is completely worn out; instead of cartilage, a system of osteophytes + false fixed interosteophytic joints is developed at the bone ends. The anatomical shape is completely disrupted. Articular ligaments and muscles are shortened and thickened. The slightest injury can cause dislocations, fractures, and cracks. The trophism of the locomotor organs is damaged, so they do not receive the required amount of blood and nutrients. Pinched nerves lead to a severe pain reaction, which only goes away after the administration of strong painkillers or drugs from the COX1/COX2 group.

Conventionally, one more stage can be added: the fourth - final stage with a vivid clinical picture of inflammation, infection, unbearable pain, immobilization of diseased joints, high fever and a severe condition. This stage is the most severe, which can lead to sepsis and death.

Arthrosis pain syndrome

Pain is characteristic of arthrosis. They intensify with movement, physical activity, with changes in weather conditions, with changes in temperature, humidity levels and atmospheric pressure. Pain can be triggered by any body position or sudden movements. Walking, running, and prolonged vertical standing put a certain load on the sore joints, after which acute or aching pain begins. In the first and second stages of the pathology, the pain syndrome disappears without a trace after a night's rest, but in the advanced stage the pain is constant and does not go away. The affected shock-absorbing layer, pinched nerves and blood vessels lead to a stagnant process with impaired trophism and the accumulation of interstitial fluid. Swelling provokes acute throbbing pain.

Specific to arthrosis is pain after a long rest with a sharp motor impulse; this condition is called starting pain. The mechanism of development of these pains is osteophytic zones covered with destructive remnants of cartilage tissue, fibrin and viscous fluid. When the joints move, a film of these components or detritus covers the exposed areas, lubricating them and thus absorbing pain. Blockade pain occurs after destruction products from the intra-articular space, that is, bone remnants or large connective tissue film, enter the muscles. There is another type of pain: constant, aching, bursting + independent of movements, they are characteristic of reactive synovitis.

Attention!The blockade type of pain is amenable only to surgical intervention followed by restoration of the affected joint. Treatment with folk remedies is not recommended, this is fraught with the development of purulent arthrosis with the spread of infection throughout the body, and after sepsis there are obvious morphological changes in all organs and systems.

Symptoms of joint inflammation

Symptoms are divided depending on the degree of development of the pathology. Arthrosis makes itself felt after 38-40 years, when the joint depreciation system begins to wear out, and renewed or young cartilage pads do not appear in its place. With a hormonal imbalance, "chaos" sets in in all vital systems, this also applies to the locomotor system, so in the affected areas the tissues do not regenerate, but rather destruction + deformation occurs.

Symptoms of arthrosis:

Degrees and periods of arthrosis	Description of symptoms
I degree	Weak, short-term pain with precise localization. Rapid fatigue of the sore joint. The pain intensifies after long walks, running or lifting weights, and goes away after rest. A faint clicking sound is heard when bending or other movements. There are no visual + palpation changes, the anatomical shape of the joint is preserved, no swelling is observed.
II degree	Discomfort in the affected joints, stiffness is noted after rest. Partial traffic restrictions. Night pain, as well as pain depending on weather conditions. When bending and other movements, a characteristic loud click appears. There are visual and palpation changes: the joints are enlarged and shortened, plus when pressure is applied, the patient responds sharply to acute pain.
III degree	Complete discomfort in the affected joints, joint instability or ankylosis is noted. Movement is paralyzed. There are constant sharp or aching pains at night. The anatomical shape of the joints is lost: thickening/shortening and displacement of the axis of the articular structure. There is swelling + pain when pressing. The gait is changed, due to the sparing of the organ of movement, the shape of the bone skeleton changes. Movement is carried out with the help of a cane or crutches. With morphological changes with an infectious factor or pinched nerves, a high temperature appears (37-38 degrees).
Periods of exacerbation and remission	In arthrosis, exacerbations alternate with remissions. The pathology is aggravated by physical activity. Exacerbations are caused by synovitis. The pain syndrome covers all affected areas, including the muscle corset. It reflexively spasms, forming painful contractures. Arthrosis is characterized by muscle cramps. As destruction increases, the pain syndrome becomes more pronounced. With reactive synovitis, the joint increases in size and takes on a spherical shape. Fluid appears in the joints, which upon palpation creates a fluctuation effect. During a short remission, the pain subsides, but movement is difficult.

Timely detection of pathology using diagnostic tests and consultation with the necessary specialists will help to step over the second and third stages, maintaining the functionality and health of all joint groups of the locomotor system until old age.

Diagnostic measures

Clarification of the diagnosis is based on laboratory/instrumental studies. Each case is studied differently, that is, with an individual approach to each patient.

The list of studies consists of:

• General and biochemical blood tests.
• Blood test for rheumatoid agent.
• Urine and feces analysis.
• X-ray examination: image in three positions.
• CT scan of the joint to clarify the bone structure.
• MRI of the joint: study of ligaments and muscles.
• Computed tomography.

Important!Patients with arthrosis need to consult an orthopedist, rheumatologist, endocrinologist, hematologist, oncologist, and female patients are recommended to consult a gynecologist.

Treatment regimen

Therapeutic tactics include a whole range of measures aimed at eliminating the main cause, correcting the nutritional diet, restoring lost function + a gentle lifestyle, that is, without special physical activity (long walking, running, carrying heavy objects). The therapeutic treatment regimen consists of drug therapy, local treatment, physiotherapeutic procedures and exercise therapy. In parallel with these methods, folk remedies are used.

Drug therapy for arthrosis

Complex therapy consists of:

1. Drugs of the NSAID group;
2. Painkillers (tablets + injections);
3. Medicines that relieve muscle spasms (muscle relaxants);
4. Cartilage tissue restorers (chondroprotectors);
5. Antibiotics;
6. Antihistamines;
7. Drugs that improve blood circulation;
8. Vitamins: B2, B12, PP and A;
9. Antioxidants: vitamin C;
10. Medicines based on hormonal substances.

It is recommended to include in the treatment regimen for rheumatoid arthritis:

• Medicines based on gold;
• Immunosuppressants;
• Antimalarial medicines;
• Medicines that inhibit malignant cells.

Attention!During remission of the pathology, non-steroidal anti-inflammatory drugs are not recommended; they affect the gastrointestinal tract, causing numerous ulcers, and also inhibit the process of nutrition of cartilage tissue.

Ointments for local use for arthrosis

Local treatment has a direct effect. Gels and ointments directly contact the affected tissues, quickly reaching the site, eliminating pain and inflammation. Preparations in the form of gels are widely used to restore the cartilage layer. Warming + anti-inflammatory ointments are used for local application.

Physiotherapy

Relief of spasmodic pain with reduction of inflammation + improvement of trophism and innervation is performed with the help of physiotherapy. Exacerbation phases are eliminated or shortened by laser therapy, magnetic fields and ultraviolet irradiation. In the remission phase of arthrosis, that is, during the calm phase, electrophoresis procedures using dimethyl sulfoxide and anesthetics are useful. Destructive and inflammatory processes are affected by phonophoresis with glucocorticosteroids, inductothermy, thermal applications of ozokerite or paraffin, as well as sulfide, radon and sea baths. The muscle corset is strengthened using electrical stimulation.

Surgery

The problem of a deformed/ankylosed joint is finally solved by surgical operations such as endoprosthetics, as well as a palliative method of unloading the articular frame (coxarthrosis is eliminated by transtrochanteric osteotomy + fenestration of the femoral fascia; gonarthrosis is corrected by arthrotomy with cleansing of the intra-articular space from the remains of destruction plus artificial cartilage augmentation). If the bone is completely incapacitated, it is replaced with an artificial graft, and the axis of the tibia is corrected.

Folk remedies

Traditional medicine helps to get rid of pain and inflammation, it temporarily eliminates pain and restores lost function. There are isolated cases of complete healing through traditional methods using the following tinctures, ointments and compresses:

1. Garlic tincture + onion and honey: 100 g of garlic pulp + 100 g of chopped onion + 2 large spoons of honey + 200 ml of vodka. Infuses for 3-5 days. Apply in the form of compresses and rubbing.
2. Sabelnik in the form of tincture: 200 g of dry powder or fresh gruel + 200 ml of diluted medical alcohol, leave for 24 hours. Drink a spoon before meals 3 times a day.
3. Ointment based on badger fat and propolis: rub for joints, apply twice a day.
4. Table horseradish + honey: 100 g horseradish + 100 g honey + 100 ml vodka. Infuse for 24 hours, drink 20 drops. This tincture can be rubbed on sore joints 3-5 times a day.
5. Hot pepper ointment + pork fat: 1 teaspoon of powder + 200 g of fat. Infuses for 2-3 days. Used as a warming local medicine. Apply 1-2 per day.
6. Compress: oak bark + spruce needles: 200 g oak bark + 200 g crushed spruce needles + 100 ml alcohol.

All of the listed recipes from traditional healers are recommended to be used only after consulting a doctor. If the patient is allergic to certain medications, their use is strictly prohibited, as they can lead to anaphylactic shock.

Features of prevention

Prevention is an effective tool for preventing joint disease, destruction and deformation. For preventive purposes, you need to do the following:

• Adjust the menu, from which exclude fried, fatty, peppery, salty, alcohol + nicotine.
• Add jelly and jellies to your daily menu.
• Avoid tiring loads.
• Increase safety precautions to avoid injury.
• Constantly perform a special set of exercises for the locomotor system.
• Try to take vitamins B and C.
• For preventive purposes, take chondroprotectors, calcium, potassium supplements, plus other minerals once every six months.
• After a joint sprain or mechanical injury, be examined by a doctor.

The list is joined by performing constant physical exercises to improve blood supply, innervation and restoration of the cartilage layer of the joints. These exercises are prescribed by a doctor.

Summary

Destruction with deformation of the joints begins after 38-40 years, so there is no need to delay the fight against this pathology. A neglected condition can lead to a wheelchair, and a timely response to the disease with effective treatment is a clear success towards recovery. It is impossible to treat arthrosis on your own; this type of pathology refers to metabolic disorders directly related to changes in hormonal levels or chronic pathologies of other systems. At the first symptoms, contact a traumatologist or surgeon, do not delay, otherwise you will only be treated in a surgical department with long rehabilitation.